‘Isn’t Everyone a Little OCD?’ The Epistemic Harms of Wrongful Depathologization

Abstract

This article develops the concept of wrongful depathologization, in which a psychiatric disorder is simultaneously stigmatized (because of sanist attitudes towards mental illness) and trivialized (as it is not considered a “proper” illness). We use OCD as a case study to argue that cumulatively these two effects generate a profound epistemic injustice to OCD sufferers, and possibly to those with other mental disorders. We show that even seemingly positive stereotypes attached to mental disorders give rise to both testimonial injustice and wilful hermeneutical ignorance. We thus expose an insidious form of epistemic harm that has been overlooked in the literature.

A Critical Analysis of UK Media Characterisations of Long Covid in Children and Young People

“…Wrongful depathologisation has been seen in both ME/CFS and obsessive compulsive disorder, 10 and constitutes an epistemic injustice. 10,12,56…”

“…Wrongful depathologisation has been seen in both ME/CFS and obsessive compulsive disorder, 10 and constitutes an epistemic injustice. 10,12,56 In addition, there was an implicit narrative that Long Covid is "just fatigue". One HCP stated that "most people will experience some level of post-viral fatigue at some point in their lives", 39 with another HCP noting "the good news is that the majority of young people who get chronic fatigue tend to get better with appropriate support."…”

Stigma as a barrier to early intervention among youth seeking mental health services in Ontario, Canada: a qualitative study

“…For example, in a recent study [48], youth reported invalidating experiences such as not feeling heard or seen by providers, being turned away from services, and nonrecognition of the severity of their symptoms. Wrongful depathologization, such as when the severity of mental health problems is trivialized by providers, can increase stigma as it reinforces stereotypes that service users exaggerate their symptoms [49].…”

Neurodiversity, epistemic injustice, and the good human life

“…While advocating this, we wish to retain a clear distinction between medicalization and pathologization (Spencer & Carel, 2021). Pathologization is a social process of coming to view certain behaviors as "abnormal, unhealthy, and requiring special treatment," while medicalization is to classify such pathologized behavior as a medical disorder (ibid.…”

“…In particular, we advocate the models developed by autistic scholars and activists, which seek to replace the fundamental axioms, assumptions, and models that the medical deficit view is based on (e.g., Chapman, 2021; Walker, 2012). While advocating this, we wish to retain a clear distinction between medicalization and pathologization (Spencer & Carel, 2021). Pathologization is a social process of coming to view certain behaviors as “abnormal, unhealthy, and requiring special treatment,” while medicalization is to classify such pathologized behavior as a medical disorder (ibid.…”